|
|
|
| Effect of target-oriented management of regional cerebral oxygen saturation monitoring on early cognitive function in the elderly after laparoscopic radical resection of colorectal cancer under general anesthesia |
| WANG Jing WANG Jie |
| Department of Anesthesiology, Suzhou Ninth People’s Hospital, Jiangsu Province, Suzhou 215200, China |
|
|
|
Abstract Objective To explore the effect of target-oriented management of regional cerebral oxygen saturation (rScO2) monitoring on early cognitive function in the elderly after laparoscopic radical resection of colorectal cancer under general anesthesia. Methods Ninety-two elderly patients with colorectal cancer admitted to Suzhou Ninth People's Hospital, Jiangsu Province, from January 2020 to December 2021 were selected as research objects. They were divided into control group and study group, with 46 cases in each group. The control group received routine anesthesia monitoring management, and study group was combined with rScO2 monitoring on the basis of control group. The cognitive function of two groups before operation and 24 h after operation were compared; heart rate, mean arterial pressure (MAP), lactate level, and body temperature were compared before operation (T0), 30 min after anesthesia (T1) and 5 min after extubation (T2); 24 h postoperative analgesia was compared between two groups; the occurrence of perioperative adverse reactions was recorded in two groups. Results The scores of mini-mental state examination scale 24 h after operation in two groups were lower than those before operation, and study group was higher than control group, and the differences were statistically significant (P＜0.05). At T2, heart rate of study group was lower than that at T0 and T1; MAP and lactic acid were higher than those at T0 and T1, and the differences were statistically significant (P＜0.05). At T1, heart rate of study group was lower than that that at T0; lactic acid was higher than that at T0, and the differences were statistically significant (P＜0.05). At T2, heart rate and MAP of control group was lower than that at T0; lactic acid were higher than those at T0 and T1, and the differences were statistically significant (P＜0.05). At T1, heart rate of control group was lower than that at T0, MAP and lactic acid were higher than those at T0, and the differences were statistically significant (P＜0.05). At T2, lactic acid in study group was lower than that in control group, and the difference was statistically significant (P＜0.05); at T1, MAP of study group was higher than that of control group, and lactic acid was lower than that of control group, and the differences were statistically significant (P＜0.05). There was no significant difference in body temperature between two groups at different time points (P＞0.05). There was no significant difference in 24 h postoperative analgesic effect between two groups (P＞0.05). There was no significant difference in the total incidence of perioperative adverse reactions between two groups (P＞0.05). Conclusion Target-oriented management of rScO2 monitoring should be used in radical resection of colorectal cancer in elderly patients under general anesthesia to help reduce the risk of postoperative cognitive dysfunction in patients.
|
|
|
|
|
|
[1] 张奕文，陈汉文，张忠其，等.依托咪酯对老年患者腹腔镜下结直肠癌术后早期认知功能及血浆皮质醇的影响[J].广州医科大学学报，2018，46（2）：23-26.
[2] 谢金兰，谷建华，黄美玲，等.CO2气腹持续时间对老年结直肠癌根治术中血气及苏醒质量的影响[J].基因组学与应用生物学，2019，38（9）：4303-4308.
[3] 张晓，余先昊.腹腔镜结直肠癌根治术对老年结直肠癌患者术后胃肠功能恢复的影响[J].中国老年学杂志，2021， 41（11）：2283-2286.
[4] 陈高瀚，金冬春.腹腔镜根治术对老年结直肠癌患者应激反应、炎症反应和细胞免疫功能的影响[J].中国老年学杂志，2020，40（6）：1177-1180.
[5] 代晨旭，张野.右美托咪定应用于老年结直肠癌根治术中对麻醉苏醒期及神经认知功能的保护作用[J].中国老年学杂志，2021，41（10）：2093-2096.
[6] 陈岗，张俊霞，邓立琴，等.充气加温毯对腹腔镜结直肠癌根治性切除术老年患者术后恢复质量和认知恢复的影响[J].中华老年医学杂志，2021，40（10）：1299-1303.
[7] 肖娜.不同麻醉方式对直肠癌根治术后患者认知功能及安全性的影响[J].医学临床研究，2019，36（2）：396-397，398.
[8] 田剑波，温艳，杨卓煜，等.全球结直肠癌筛查指南及共识质量评价[J].中华流行病学杂志，2021，42（2）：248-257.
[9] 刘叶，李红，刘枝，等.不同麻醉方式对老年女性腹腔镜手术患者术后认知功能的影响[J].河北医科大学学报，2021，42（7）：846-850.
[10] 白日虹，贾志勇，张晓婷，等.腹腔镜胃癌D2根治术中右美托咪定麻醉效果及对术后血流动力学、疼痛视觉模拟评分及Ramsay镇静评分的影响[J].肿瘤研究与临床，2019，31（10）：666-669.
[11] 马松梅，孔莉，方传奇.全身麻醉联合硬膜外麻醉对老年结直肠癌根治术患者组织灌注及肠道屏障的影响[J].中华老年医学杂志，2021，40（1）：102-106.
[12] 沈焘，孙圣茜，夏翠峰，等.老年结直肠癌根治术后预后分析[J].中国老年学杂志，2018，38（15）：3645-3647.
[13] 唐毅，李玉娟，陈亚，等.经皮穴位电刺激联合全身麻醉对腹腔镜结直肠癌根治术患者炎性因子、T细胞亚群和认知功能的影响[J].现代生物医学进展，2020，20（23）：4571-4575.
[14] 蒋蓉娟，孙燕，刘少星，等.右美托咪定麻醉对老年结直肠癌根治术患者术后认知功能及血流动力学的影响[J].医学临床研究，2019，36（7）：1297-1299.
[15] 李集源，刘健欣，陈汉文，等.不同剂量咪达唑仑对术前中重度焦虑结直肠癌老年患者术后早期认知功能的影响[J].中国现代医学杂志，2021，31（17）：5-11.
[16] 安慎通，皇甫加文，闵昱源.全麻腹腔镜手术对老年直肠癌 患者术后认知功能的影响及危险因素分析[J].海南医学，2020，31（9）：1149-1151.
[17] 牟俊英，刘涛，叶刚，等.超声引导腰方肌阻滞联合全身麻醉对老年结直肠癌患者术后早期认知功能及应激的影响[J].中国医药导报，2020，17（7）：106-110.
[18] 梁仁芮，崔晓媛，王春燕.后腹腔镜下CO2气腹对老年患者脑氧饱和度及S-100β蛋白的影响[J].中国临床研究，2020，33（4）：485-487，492.
[19] 张晓，毕燕琳，王玲，等.老年腹腔镜胃肠手术患者脑氧代谢与术后谵妄的关系[J].精准医学杂志，2019，34（2）：152-154，158.
[20] 郭宗锋，王祥，曹苏，等.右美托咪定联合乌司他丁对行腹腔镜下结直肠癌手术的老年患者围术期神经认知障碍的影响——多中心、随机、双盲、对照研究[J].中国全科医学，2020，23（36）：4578-4584.
[21] 朱泽飞，孙振涛，杨贯宇，等.长时间CO2气腹和Trendelenburg体位对中老年患者直肠癌根治术中脑氧饱和度的影响[J].临床麻醉学杂志，2020，36（2）：152-155.
[22] 王舒，金宁，刘娇，等.不同脑电双频指数对老年患者全身麻醉下腹腔镜结肠癌根治术后早期认知功能及局部脑氧饱和度的影响[J].癌症进展，2021，19（11）：1148-1152.
[23] 陈小刚，汪正伟.右美托咪定对老年结直肠癌患者术后认知功能及血浆miR-206、BDNF水平的影响[J].东南大学学报（医学版），2021，40（4）：442-449.
[24] 董福生，李广伟，孟卉，等.右美托咪定多模式镇痛对老年结直肠癌根治术后的镇痛效果及其对认知功能的影响[J].川北医学院学报，2021，36（2）：180-183.
[25] 程磊，蒋宇，郑立东.脑氧监测目标导向管理对老年胸腔镜食管癌根治术病人术后谵妄的影响[J].安徽医药，2021，25（6）：1190-1193. |
|
|
|
